Types of personality disorder
Having a healthy personality enables a person to function in daily life. Everyone experiences stress at some time, but, a healthy personality helps us to face the challenges and move on.
For someone with a personality disorder, the features of everyday life that most people take for granted can become a challenge.
There are many types of personality disorder, but this article will focus on a few of them.
What is personality?
An individual's personality is what defines how they perceive the world around them. It is a set of characteristics and features that cause them to think, feel, and act in a particular way.
Genetic make-up, biological, and environmental factors all help to shape an individual's personality.
Personality stems from genetic, biological, and environmental factors, and it is what makes us all individuals.
When an individual has a personality disorder, it becomes harder for them to respond to the changes and demands of life and to form and maintain relationships with others.
These experiences can lead to distress and social isolation and increase the risk of depression and other mental health issues.
The American Psychiatric Association's (APA) Diagnostic and Statistical Manual fifth edition (DSM-5) lists a number of personality disorders as diagnosable conditions for which people can seek treatment.
The DSM-5 groups personality disorders into three broad clusters that it refers to as A, B, and C.
Cluster A personality disorders
These disorders involve behavior that seems unusual and eccentric to others, according to Mental Health America (MHA).
- paranoid personality disorder
- schizoid personality disorder
- schizotypal personality disorder
Cluster B personality disorders
These disorders feature behavior that is emotional, dramatic, or erratic.
- antisocial personality disorder
- borderline personality disorder
- histrionic personality disorder
- narcissistic personality disorder
Cluster C personality disorders
Anxiety and fear underlie the behaviors that occur with Cluster C disorders.
Examples of these include:
- avoidant personality disorder
- dependent personality disorder
- obsessive-compulsive personality disorders
To receive a diagnosis of a personality disorder, an individual must meet certain criteria.
MHA describe a personality disorder as "A deeply ingrained, inflexible pattern of relating, perceiving, and thinking serious enough to cause distress or impaired functioning."
These disorders probably result from a combination of genetic and environmental factors.
Paranoid personality disorder
A person with paranoid personality disorder finds it hard to trust others. They might think that people are lying to or manipulating them, even when there is no evidence of this happening.
A person may experience:
- mistrust and suspicion
- anxiety about someone taking advantage of them
- anger over perceived abuse
- concern about hidden meanings or motives
The inability to trust others can make it hard for the person to maintain relationships with those around them.
Around 2–4 percent of the general population may have this disorder.
Schizoid personality disorder
A person with schizoid personality disorder may feel more comfortable with a pet than with another person.
A person with schizoid personality disorder often feels uncomfortable when they have to relate to others.
It affects fewer than 1 percent of the population.
Others may see the person as aloof, detached, cold, or as a "loner."
The person will tend to:
- avoid close social contact with others
- have difficulty forming personal relationships
- seek out employment that involves limited personal or social interaction
- react to situations in ways that others consider inappropriate
- appear withdrawn and isolated
The person may form attachments with objects or animals, rather than people.
Individuals with this personality disorder may have relatives of with schizophrenia or schizotypal personality disorder.
Schizotypal personality disorder
People with schizotypal personality disorder may have few close relationships outside their own family.
This is because they have difficulty understanding how relationships develop and also how their behavior affects others. They may also find it hard to understand or trust others.
For a diagnosis, the person will show or experience five or more of the following behaviors:
- ideas of reference, for example, when a minor event happens, the person believes it has special significance for them
- odd beliefs or magical thinking which influences their behavior, such as superstitious thinking, beliefs in telepathy, or bizarre fantasies or preoccupations
- unusual perceptual experiences, including bodily illusions
- odd thinking and speech, for example, metaphorical thinking and overelaboration
- signs of suspiciousness or paranoid thinking
- inappropriate or bizarre facial expressions
- behavior or appearance that seems odd, eccentric, or peculiar
- a lack of close friends and confidants, other than first-degree relatives
- excessive social anxiety
A person with this condition has a higher risk of developing schizophrenia in the future.
Antisocial personality disorder
A person with antisocial personality disorder (ASPD) acts without regard to right or wrong or without thinking about the consequences of their actions on others.
This can result in:
- irresponsible and delinquent behavior
- novelty-seeking behavior
- violent behavior
- a risk of criminal activity
Around 1–3 percent of the general population have ASPD, but around 40–70 percent of people in prisons have it, according to authors who published a study in 2016.
Having conduct disorder before the age of 15 years significantly increases the risk of having ASPD later in life. It is more likely to affect men than women.
The researchers looked at specific genetic features in 543 participants. They found similar genetic features in people with the disorder, as well as low levels of grey matter in the frontal cortex area of the brain. Genetic, biological, and environmental factors probably all play a role.
Borderline personality disorder
A person with borderline personality disorder will have trouble controlling their emotions.
They may experience:
- mood swings
- shifts in behavior and self-image
- impulsive behavior
- periods of intense anxiety, anger, and depression, boredom
These intense feeling can last for only a few hours or for much longer periods, lasting several days. They can lead to relationship difficulties and other challenges in daily life.
According to the National Institute of Mental Health (NIMH), this can result in:
- rapid changes in how the person relates to others, for example, shifting suddenly from closeness to anger
- risky behaviors, such as dangerous driving, and spending sprees
- self-harming behavior
- poor anger management
- a sense of emptiness
- difficulty trusting others
- recurrent suicidal behaviors, gestures, threats, or self-mutilation, such as cutting
- feelings of detachment, or dissociation
Histrionic personality disorder
A person with histrionic personality disorder feels a need for others to notice them and reassure them that they are significant. This can affect the way the person thinks and acts.
Researchers writing in 2015 called it "one of the ambiguous diagnostic categories" in mental health.
The person may feel a strong need to be loved, and they may also feel as if they are not strong enough to cope with everyday life alone.
It may lead to behavior that appears:
- provocative and flirtatious
- excessively emotional or dramatic
- emotionally shallow
- insincere, as likes and dislikes shift to suit those around the person
- risky, as the person constantly seeks novelty and excitement
The person may function well in social and other environments, but they may also experience high levels of stress. This can lead to depression and anxiety.
The features of histrionic personality disorder can overlap with and be similar to those of narcissistic personality disorder.
Narcissistic personality disorder
This disorder features a sense of self-importance and power, but it can also involve feelings of low self-esteem and weakness.
A person with this condition may show the following personality traits:
- have an inflated sense of their own importance, attractiveness, success, and power
- crave admiration and attention
- lack regard for others' feelings
- overstate their talents or achievements
- expect to have the best of everything
- experience hurt and rejection easily
- expect others to go along with all their plans and ideas
- experience jealousy
- believe they should have special treatment
- believe they should only spend time with other people who are as special as them
- appear arrogant or pretentious
- be prone to impulsive behavior
They may also have a higher risk of:
- mood, substance, and anxiety disorders
- low self-esteem and fear of not being good enough
- feelings of shame, helplessness, anger at themselves
- impulsive behavior
- using lethal means to attempt suicide
These features can make it hard to maintain healthy relationships and to function in daily life.
Avoidant personality disorder
Avoidant personality disorder can make it hard to form friendships.
A person with avoidant personality disorder avoids social situations and close interpersonal relationships, mainly due to a fear of rejection and feeling that they are not good enough.
- feel inadequate
- have low self-esteem
- find it hard to trust people
They may appear extremely shy and socially inhibited.
A person with avoidant personality disorder may want to develop close relationships with others, but they lack the confidence and ability to form relationships.
There may also be a higher risk of substance abuse, an eating disorder, or depression. The person may think about or attempt suicide.
Dependent personality disorder
A person with this condition may have the following characteristics:
- has an excessive need to be taken care of by others
- is overly-dependent on others
- has a deep fear of separation and abandonment
- invests a lot of energy and resources in trying to please others
- goes to great lengths to avoid disagreement and conflict
- is vulnerable to manipulation by others
- is willing to undergo mistreatment to maintain a relationship
- does not like to be alone
Others may see the person's behavior as:
The person often lacks confidence in themselves and their abilities. It is difficult for them to undertake projects independently, or to make decisions without help. They may find it hard to take responsibility.
A study published in 2011 concluded that people with a dependent personality disorder are vulnerable to ill-treatment from others, including domestic abuse.
This can lead to further complications, such as depression and anxiety.
Obsessive-compulsive personality disorder
A person with OCPD can find it difficult to accept when something is not perfect.
Obsessive-compulsive personality disorder (OCPD) is not the same as obsessive-compulsive disorder (OCD). Some people may experience both, however, and researchers say there appears to be a link between them.
An excessive concern with perfectionism and hard work dominate the life of a person with OCDP. The individual may prioritize these ideals to the detriment of close personal relationships.
According to the International OCD Foundation, a person with OCPD may:
- appear inflexible
- feel an overwhelming need to be in control
- find that concerns about rules and efficiency make it hard to relax
- find it hard to complete a task, for fear that it is not perfect
- be uncomfortable when things are messy
- have difficulty delegating tasks to others
- be extremely frugal when it is not necessary to do so
- hoard items
- may be highly efficient in the workplace
Others may see the individual as sanctimonious, stubborn, uncooperative, and obstinate.
According to the International OCD Foundation, one difference between OCD and OCPD is that OCD relates to everyday tasks, while OCPD focuses specifically on following procedures.
In addition, OCD can interfere with the way a person functions in everyday life, whereas OCPD can enhance a person's professional performance, while possibly interfering with their life outside of work.
Treatment and outlook
Personality disorders often share features, and it can be hard to distinguish between them, but the DSM-5 provides criteria for an appropriate diagnosis.
Following a diagnosis, treatment can help people with different kinds of personality disorder.
Often the person does not feel there is anything wrong with their behavior, but they may seek help because they are experiencing social isolation and fear.
However, depression, anxiety, and other mental health issues can result from living with a personality disorder. For this reason, it is important to seek help early.
A doctor may prescribe medication and recommend therapy or counseling. Individual, group, and family counseling can help.
In time, this can make it easier for the person to function in everyday life and to maintain healthy relationships with others.